The college’s discipline committee ruled on July 21 that Ghumman “committed an act of professional misconduct in that he has failed to maintain the standard of practice of the profession.”

Ghumman, who received his medical degree in Pakistan in 1982, can’t reapply for a chief of staff position at any hospital until he completes a reassessment.

For the next 12 months, he can only practise under the eye of a clinical supervisor. Six months after the supervision period, Ghumman must undergo, at his own expense, a re-assessment of his practice.

Ghumman must also inform the college of every location he practices within 15 days. He is also subject to unannounced inspections of his practice and patient charts, as well as other demands the college makes to monitor him.

Along with paying for any costs associated with enforcing the college’s order, Ghumman must pay the $5,500 cost of his disciplinary hearing.

The College of Physicians and Surgeons said in a written summary that a patient, who has not been named, filed a complaint in June 2015 about Ghumman’s conduct during gallbladder removal surgery and post-operative care.

Several months before that, Ghumman told the woman she had gallstones. He conducted laparoscopic gallbladder removal surgery.

The college said that during the surgery, a clip applier that Ghumman put on the patient’s cystic artery became jammed and couldn’t be pulled off because it might have damaged an artery.

Ghumman considered switching to an open procedure, which means he would have had to remove the gallbladder through a large cut in the abdomen. But the college said he decided to continue with the laparoscopic surgery and divide the cystic artery to remove the jammed clip applier.

This required applying more clips. At one point, the college said, Ghumman became concerned that he might have mistakenly put a clip on a bile duct or artery and didn’t know how to get it off.

He ultimately took out the first jammed clipper and the gallbladder, which tore while he was removing it. Ghumman finished the surgery but noted in his report that there might by a clip still on the common bile duct.

After that, he told the patient that the surgery went well. The college said he indicated he might have placed on a clip on the woman’s right hepatic artery or common bile duct, but still sent her home the same day.

When the patient returned two days later for monitoring, she said she didn’t feel well.

Ghumman told the woman’s family doctor there was a “small incident” during surgery, but after a scan he was satisfied there was no clip on the bile duct. He said he was initially concerned because he applied the clip “a little bit blind,” but felt the clip was on the tissues along the gallbladder, which was not a problem.

The patient returned three days later for some tests and reported “feeling itchy.” She also couldn’t eat and looked jaundiced. After some blood work, Ghumman told the patient the jaundice might be a symptom of problems with the liver or bile duct, which could also account for the itching.

He told her to stay hydrated. But the woman continued to complain the itching was getting worse. Ghumman booked an ultrasound, which found that the common bile duct was obstructed.

He told the patient he was now concerned that the clip was “placed incorrectly” and likely caused the bile duct obstruction.

Ghumman immediately sent the woman to London Health Sciences Centre for emergency surgery. The surgeon in London noted that there was a clip going across the patient’s entire bile duct. The surgery to remove it was complicated by bleeding, which required a transfusion of eight units of blood. She remained in hospital in London for a week.

The college later launched a general investigation into Ghumman’s surgical practice. The experts found that he engaged in “prolonged and unnecessary use” of antibiotics for some patients following surgery.

The college also determined he overused surgical drains in some patients without evidence that it was required. He also had deficient record-keeping and incomplete documentation relating to patients’ consent to colonoscopies.

The college said there was no evidence of those issues causing harm to any patients.

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